Computers in orthodontics

ss
Relevance of ComputersRelevance of Computers
In OrthodonticsIn Orthodontics
&&
Digital RadiographyDigital Radiography
www.indiandentalacademy.comwww.indiandentalacademy.com

General applicationsGeneral applications
 Word ProcessingWord Processing
 AccountingAccounting
 Data Base ManagementData Base Management
 PresentationsPresentations
 E-mail Usage etc.E-mail Usage etc.

Clinical ApplicationsClinical Applications
 1. Pt records storage & retrieval1. Pt records storage & retrieval
 2. Pt. records evaluation & treatment2. Pt. records evaluation & treatment
planningplanning
 3. Pt. motivation3. Pt. motivation
 4.Computerised Imaging4.Computerised Imaging
 5.Computerised cephalometrics5.Computerised cephalometrics
 6.Computerised Growth prediction6.Computerised Growth prediction

Other ApplicationsOther Applications
 1.Continuing education1.Continuing education
 2. Research2. Research
 3. Case presentations3. Case presentations

Computer basedComputer based
imaging modalitiesimaging modalities

 Computed TomographyComputed Tomography
 3-D-Computerised Tomography3-D-Computerised Tomography
 Magnetic resonance ImagingMagnetic resonance Imaging
 VideoimagingVideoimaging
 OrthoCAD 3D- Virtual study modelsOrthoCAD 3D- Virtual study models
 DigigraphDigigraph
 Digital photographyDigital photography
 Digital radiographyDigital radiography

Computed tomography (C.T )Computed tomography (C.T )
Also called (CAT) or computed axialAlso called (CAT) or computed axial
tomographytomography
A technique that blends the conceptA technique that blends the concept
of thin-layer radiography withof thin-layer radiography with
computer synthesis of image.computer synthesis of image.

 X-ray beam attenuation measurements areX-ray beam attenuation measurements are
made in a 360-deg circle around the part ofmade in a 360-deg circle around the part of
the patient's body being scanned.the patient's body being scanned.
 These measurements are then fed to theThese measurements are then fed to the
computer, which constructs the image fromcomputer, which constructs the image from
them.them.

3-Dimensional Computerised3-Dimensional Computerised
TomographyTomography
 3D-CT scans for the maxillofacial area has3D-CT scans for the maxillofacial area has
been introduced (NEWTOM-9000).been introduced (NEWTOM-9000).

 Data acquisition takes 70 seconds andData acquisition takes 70 seconds and
patients are exposed to a radiation dose 20patients are exposed to a radiation dose 20
times lower than with a normal CT dentaltimes lower than with a normal CT dental
scan.scan.
 generates 3-D images using a single conicalgenerates 3-D images using a single conical
x-ray beamx-ray beam

Magnetic ResonanceMagnetic Resonance
ImagingImaging
 Makes use of two fundamental propertiesMakes use of two fundamental properties
of protons, i.e spin & small magneticof protons, i.e spin & small magnetic
movements.movements.
 The proton of hydrogen ion which is inThe proton of hydrogen ion which is in
water is utilized in MRIwater is utilized in MRI

Working of MRI:Working of MRI:
 Patient placed in a magnetic fieldPatient placed in a magnetic field
 A radio wave is sent inA radio wave is sent in
 Radio wave turned offRadio wave turned off
 Patient emits signalPatient emits signal
 Signal received and used for imageSignal received and used for image
reconstructionreconstruction

Advantages:Advantages:
-- Non-ionizing, harmless to the patient.-- Non-ionizing, harmless to the patient.
-- Soft tissue lesions diagnosed with ease-- Soft tissue lesions diagnosed with ease
-- Hard tissue destruction visualized better-- Hard tissue destruction visualized better
than CT.than CT.
-- Imaging of blood flow, visualization of-- Imaging of blood flow, visualization of
thrombus is possible.thrombus is possible.
-- Useful in pregnant women, young-- Useful in pregnant women, young
children where X-radiation doses arechildren where X-radiation doses are
restricted.restricted.

Disadvantages:Disadvantages:
Requires large cumbersome machinery.Requires large cumbersome machinery.
• ExpensiveExpensive
• Cannot be used in patients withCannot be used in patients with
electrically and magnetically activatedelectrically and magnetically activated
implants e.g. cardiac pacemakers,implants e.g. cardiac pacemakers,
infusion pumps etc.infusion pumps etc.
• Time consumingTime consuming
• Strong magnetic fields cause anxietyStrong magnetic fields cause anxiety
and emotional stress to some patients.and emotional stress to some patients.

The SOMATOM Sensation 64The SOMATOM Sensation 64 acquiresacquires
64 slices per rotation.64 slices per rotation.
 Its unmatched clinical performanceIts unmatched clinical performance
empowered by the Siemens uniqueempowered by the Siemens unique
STRATON tube and z-Sharp TM TechnologySTRATON tube and z-Sharp TM Technology
allows good diagnostic details.allows good diagnostic details.

 It is possible to image the smallest pathologyIt is possible to image the smallest pathology
and finest anatomical structures in just a fewand finest anatomical structures in just a few
seconds.seconds.
• Additionally, optimized
workflow enhances
clinical performance
while maintaining
patient focus and
comfort

VideoimagingVideoimaging
It has the potential to touch almost everyIt has the potential to touch almost every
aspect of orthodontic practice:aspect of orthodontic practice:
 Diagnosis and treatment planning,Diagnosis and treatment planning,
 Patient communication at consultationsPatient communication at consultations
 Data base maintenanceData base maintenance
 Practice managementPractice management
 Communication with other officesCommunication with other offices

 In a study by Kiyak at the University ofIn a study by Kiyak at the University of
Washington, 6 months after orthognathicWashington, 6 months after orthognathic
surgery in asurgery in a nonimaged populationnonimaged population, only 45%, only 45%
of patients reported satisfaction with theof patients reported satisfaction with the
esthetic outcome of their procedures.esthetic outcome of their procedures.
 In the same time period postoperatively in anIn the same time period postoperatively in an
imaged populationimaged population, we found that 89% of, we found that 89% of
patients reported satisfaction with the estheticpatients reported satisfaction with the esthetic
outcome of orthognathic surgery.outcome of orthognathic surgery.

Pre-
treatment
Prediction
after
orthognathic
surgery
Post-
treatment

 As imaging provides a common visualAs imaging provides a common visual
template for both doctor and patient, realistictemplate for both doctor and patient, realistic
treatment plans and expectations of thetreatment plans and expectations of the
outcome can be modeled.outcome can be modeled.
 Obviously, a great deal of research must beObviously, a great deal of research must be
done in the future before we can completelydone in the future before we can completely
integrate this technology into our treatment ofintegrate this technology into our treatment of
patients. These studies are just beginning.patients. These studies are just beginning.

 I feel confident that computerized video-I feel confident that computerized video-
imaging will help expand our vision as weimaging will help expand our vision as we
strive to deliver the best care possible;strive to deliver the best care possible;
nevertheless, we must evaluate thisnevertheless, we must evaluate this
technology rationally and define its strengthstechnology rationally and define its strengths
and weaknesses just as clearly as we have forand weaknesses just as clearly as we have for
our cephalometric tools.”our cephalometric tools.”
(Videoimaging: The pros and cons -David M.(Videoimaging: The pros and cons -David M.
Sarver Angle Orthod, 1993 No. 3, 167 - 170:)Sarver Angle Orthod, 1993 No. 3, 167 - 170:)

OrthoCAD 3D Virtual StudyOrthoCAD 3D Virtual Study
ModelsModels

 The procedure to obtain a Virtual StudyThe procedure to obtain a Virtual Study
Model is simple and relatively easy fromModel is simple and relatively easy from
manufacturing a Plaster Study Model.manufacturing a Plaster Study Model.
 Take an alginate impression and wax bite ofTake an alginate impression and wax bite of
the patient.the patient.
 Send the alginate impression along with theSend the alginate impression along with the
wax bite to the 3D service centre.wax bite to the 3D service centre.
 Within a week the models are downloadedWithin a week the models are downloaded
on the user’s computer automatically viaon the user’s computer automatically via
Internet.Internet.

 The 3 basic components of user’s system:The 3 basic components of user’s system:
 download utility on internet ready PC(gateway)download utility on internet ready PC(gateway)
 designated folder for the incoming modelsdesignated folder for the incoming models
 a 3D browser, allowing the clinician to make usea 3D browser, allowing the clinician to make use
of the digital information.of the digital information.

 Casts viewed from different aspects --Casts viewed from different aspects --
Rotator software. Users can visualizeRotator software. Users can visualize
maxillary and mandibular casts in-maxillary and mandibular casts in-
 the frontal view,the frontal view,
 right and left lateral view,right and left lateral view,
 gallery view,gallery view,
 occlusal viewocclusal view

 Occlusogram: It depicts a color-codedOcclusogram: It depicts a color-coded
scheme of the bite registration and includesscheme of the bite registration and includes
points of full contact between the teeth.points of full contact between the teeth.
On-screen caliper:
Allows easy cast
measurements using
the grid and allows
full cast analysis of
these virtual casts.

Advantages:Advantages:
 Patient educationPatient education
 LessLess storage spacestorage space::
 Less time & manpower-Less time & manpower- only timeonly time
consumed to download the 3D virtual modelsconsumed to download the 3D virtual models
from the internet & requires minimalfrom the internet & requires minimal
manpower.manpower.

 Instant communicationInstant communication : Most important: Most important
benefit- The ability to share and exchangebenefit- The ability to share and exchange
information effectivelyinformation effectively
 Network accessNetwork access : In a dental office set: In a dental office set
upup
 Quality assuranceQuality assurance : These user friendly: These user friendly
diagnostic tools allow accurate analysisdiagnostic tools allow accurate analysis
and also allow the results to be savedand also allow the results to be saved
electronically.electronically.

 Increase ProductivityIncrease Productivity ::
 Fast access to the recordsFast access to the records
 Easy retrievalEasy retrieval
 Easy to use analysis less time required forEasy to use analysis less time required for
accurate diagnosis.accurate diagnosis.
 Cleaner Diagnostic toolCleaner Diagnostic tool :: Virtual studyVirtual study
models just require a computer to operatemodels just require a computer to operate
upon, thus no dust emanating from the casts:upon, thus no dust emanating from the casts:
A cleaner3-D option.A cleaner3-D option.

 Adequate knowledgeAdequate knowledge of computerof computer
necessary.necessary.
 PracticePractice reqd for manipulations of 3-D modelsreqd for manipulations of 3-D models
 Large practices need large computer memoryLarge practices need large computer memory
so increased cost of models.so increased cost of models.
 Not possible to relate 3-D models to the hingeNot possible to relate 3-D models to the hinge
axisaxis..
 Times consuming-Times consuming- The service centre needsThe service centre needs
a week’s time to construct and send the Virtuala week’s time to construct and send the Virtual
Models to the user.Models to the user.

Digital PhotographyDigital Photography
 Essential requirements for digitalEssential requirements for digital
photography:photography:
 ComputerComputer
 Digital cameraDigital camera
 Image storage deviceImage storage device
 PrinterPrinter

ComputerComputer
 A mid-range processor (1 Ghz) with atA mid-range processor (1 Ghz) with at
least 20 GB hard drive & 128 MB RAMleast 20 GB hard drive & 128 MB RAM
and a windows or Mac operating systemand a windows or Mac operating system
 Softwares for cataloguing, storing,Softwares for cataloguing, storing,
retrieving & minor modifications of theretrieving & minor modifications of the
pictures usually come with the camera.pictures usually come with the camera.

Digital cameraDigital camera
 In conventional photography, the images ofIn conventional photography, the images of
objects are recorded on film through chemicalobjects are recorded on film through chemical
reactions with light.reactions with light.
 In digital photography, the only difference isIn digital photography, the only difference is
the recording system. It is an electromagneticthe recording system. It is an electromagnetic
reaction of light on the sensor that capturesreaction of light on the sensor that captures
the image.the image.

 The pictures are stored in the digital formatThe pictures are stored in the digital format
on any magnetic storage device s.a internalon any magnetic storage device s.a internal
in-built memory of the camera or a memoryin-built memory of the camera or a memory
card.card.
 These can be transferred to any computerThese can be transferred to any computer
and the space is recovered by deleting themand the space is recovered by deleting them
from the camera.from the camera.

 The CCD sensors - made up of tiny pixels-The CCD sensors - made up of tiny pixels-
change light and colour into electronic codechange light and colour into electronic code
by means of analog/digital processing.by means of analog/digital processing.
 These are analogous to silver halide particlesThese are analogous to silver halide particles
on a conventional film.on a conventional film.

 CCDs are monochromous i.e detect onlyCCDs are monochromous i.e detect only
black and white.black and white.
 Colour pictures are captured by layered CCDColour pictures are captured by layered CCD
grid, which filter the individual colours likegrid, which filter the individual colours like
red, green, bluered, green, blue
 There are 256 gray shades and varyingThere are 256 gray shades and varying
levels of each colour result in total 16.7levels of each colour result in total 16.7
million coloursmillion colours

Image storageImage storage
 In-built storage has been largely replaced byIn-built storage has been largely replaced by
removable storage media, thus enablingremovable storage media, thus enabling
change of cards, if one is filled and morechange of cards, if one is filled and more
pictures need to be taken.pictures need to be taken.
 A variety of memory cards s.a smart mediaA variety of memory cards s.a smart media
cards, compact flash cards, memory stickscards, compact flash cards, memory sticks
etc. depending on individual manufactureretc. depending on individual manufacturer
are availableare available

 Transfer is facilitated by direct connectionTransfer is facilitated by direct connection
of the camera to the computer by serial,of the camera to the computer by serial,
parallel or USB ports or card drivesparallel or USB ports or card drives
connected to the computer/printer.connected to the computer/printer.
 These images are usually stored as bit-These images are usually stored as bit-
map files or may be compressed to othermap files or may be compressed to other
formats as GIF or JPEG files.formats as GIF or JPEG files.

 This is beneficial as less space is used upThis is beneficial as less space is used up
per picture but may result in loss of clarity ofper picture but may result in loss of clarity of
the same.the same.
 A bit map image constitutes of individualA bit map image constitutes of individual
pixels with each pixel containing a colour.pixels with each pixel containing a colour.

OraScannerOraScanner
 The OraScanner is a handheld scanningThe OraScanner is a handheld scanning
device that directly captures a three-device that directly captures a three-
dimensional image of the dentition in vivo.dimensional image of the dentition in vivo.
 The processed OraScan™ provides a 3-DThe processed OraScan™ provides a 3-D
image of the patient’s dentition that can beimage of the patient’s dentition that can be
viewed and measured in all planes of spaceviewed and measured in all planes of space
to define the spatial position of the entireto define the spatial position of the entire
dentition.dentition.

Additionally, the OraScan can be very
effectively used during patient visits to explain
treatment approaches and for patient
education.

Digigraph-Digigraph-
A product of Dolphin Imaging Systems,USA;A product of Dolphin Imaging Systems,USA;
it is a synthesis of video imaging, computerit is a synthesis of video imaging, computer
technology and sonic digitalizing.technology and sonic digitalizing.

 Cephalometric landmarks are digitized byCephalometric landmarks are digitized by
lightly touching thelightly touching the sonic digitizing probesonic digitizing probe
to a point on the patient’s skinto a point on the patient’s skin
corresponding to it.corresponding to it.
 This emits a sound, which is thenThis emits a sound, which is then
recorded by the microphone & monitoredrecorded by the microphone & monitored
as X,Y & Z coordinates.as X,Y & Z coordinates.

Taking digigraph recordsTaking digigraph records

 It enables the clinician to performIt enables the clinician to perform non-non-
invasiveinvasive andand non-radiographicnon-radiographic analysis.analysis.
 Has provisions for video imaging of studyHas provisions for video imaging of study
models and patient x-rays.models and patient x-rays.
 Can be fitted with high resolution camera withCan be fitted with high resolution camera with
telephoto lens for intraoral picturestelephoto lens for intraoral pictures

 It performs cephalometric analysis,It performs cephalometric analysis,
tracings, superimpositions and visualtracings, superimpositions and visual
treatment objectivestreatment objectives

 Advantages-Advantages-
 Valuable tool for improving communicationValuable tool for improving communication
among patient, clinician and staff.among patient, clinician and staff.
 Saves valuable space by eliminating bulkySaves valuable space by eliminating bulky
records.records.
 No radiation exposure to the patientNo radiation exposure to the patient
 Data transfer is fast and easyData transfer is fast and easy

DigitalDigital
RadiographyRadiography

 It offers several advantages over conventionalIt offers several advantages over conventional
x-ray filmx-ray film
 Storage & retrievalStorage & retrieval
 Reduction of pt.’s x-ray exposureReduction of pt.’s x-ray exposure
 Images displayed on computer screen ratherImages displayed on computer screen rather
than a lightbox and can be enlarged &than a lightbox and can be enlarged &
enhanced for easier viewingenhanced for easier viewing
 Ease in transferring data through internetEase in transferring data through internet
without loss of qualitywithout loss of quality

Three methods are available for acquiringThree methods are available for acquiring
digital grey scale images of radiographsdigital grey scale images of radiographs
- Phosphor plate technique- Phosphor plate technique
- Direct receptor technique- Direct receptor technique
- Transparency scanner technique- Transparency scanner technique

Conventional X-ray tubeConventional X-ray tube
Exposes Photostimulable phosphor plateExposes Photostimulable phosphor plate
Formation of a latent imageFormation of a latent image
(in the form of excited phosphors)(in the form of excited phosphors)
Plate placed in a laser scannerPlate placed in a laser scanner
(excites the phosphors to give up stored light)(excites the phosphors to give up stored light)
Digital image ---- transferred to computerDigital image ---- transferred to computer

 Scanning takes three minutes & afterScanning takes three minutes & after
scanning ,the latent image is removed byscanning ,the latent image is removed by
placing the plate over a bright light sourceplacing the plate over a bright light source
for a few minutes.for a few minutes.
 Plates are reusable & last for severalPlates are reusable & last for several
thousand exposures.thousand exposures.
 Sensitivity of the plate allows reduction inSensitivity of the plate allows reduction in
X-ray exposure up to 90% overX-ray exposure up to 90% over
conventional film-screen combinationsconventional film-screen combinations

 2 step procedure: exposure and laser2 step procedure: exposure and laser
scanning before digital image can bescanning before digital image can be
viewed.viewed.
 Slow than other digital imagingSlow than other digital imaging
modalities as scan time ranges from 2.5modalities as scan time ranges from 2.5
-5 minutes.-5 minutes.
 Dentsply -Gendex is an example of PSPDentsply -Gendex is an example of PSP
technology that is commercially viable.technology that is commercially viable.

Direct RecptorsDirect Recptors
 Make use of a photo sensitive sensor, suchMake use of a photo sensitive sensor, such
as a CCD sensor in place of x-ray film.as a CCD sensor in place of x-ray film.
 A conventional x-ray tube exposes theA conventional x-ray tube exposes the
sensor, which transfers its data through a thinsensor, which transfers its data through a thin
cable directly to the computer, where the datacable directly to the computer, where the data
are converted to a grey scale image & savedare converted to a grey scale image & saved
to disk.to disk.
 X-ray exposure to pt. is reduced by 90%X-ray exposure to pt. is reduced by 90%

Charged Couple DevicesCharged Couple Devices
 CCD sensors generate voltage maps & areCCD sensors generate voltage maps & are
used to construct the digital image.used to construct the digital image.
 CCD sensors are fitted toCCD sensors are fitted to panoramic andpanoramic and
cephalometric units to replace films.cephalometric units to replace films.
 Advantage- Relatively instant image, lowAdvantage- Relatively instant image, low
exposure dose and multiple imagesexposure dose and multiple images
acquired rapidly. Current use: intra oralacquired rapidly. Current use: intra oral
sensorssensors www.indiandentalacademy.comwww.indiandentalacademy.com

 ExpensiveExpensive
 Small, therefore the panoramic andSmall, therefore the panoramic and
cephalometric application difficult.cephalometric application difficult.
 Anatomic scanning for cephalometricAnatomic scanning for cephalometric
projections requires several seconds andprojections requires several seconds and
creates a risk for patient motion artefact.creates a risk for patient motion artefact.
 Two examples of cephalometric units usingTwo examples of cephalometric units using
this technology are Planmeca-Dirmax andthis technology are Planmeca-Dirmax and
Siemen-OrthopsSiemen-Orthops

3. Amorphous Silicon (A-SI) Sensors3. Amorphous Silicon (A-SI) Sensors
 The A-Si is deposited as a thin film on glass.The A-Si is deposited as a thin film on glass.
 So thin film transistors and sensors areSo thin film transistors and sensors are
manufactured on large substrates (> 15”manufactured on large substrates (> 15”
diagonally).diagonally).
 The A-Si array and associated electronicsThe A-Si array and associated electronics
can be packaged into standard extra-oralcan be packaged into standard extra-oral
cassette sizes to retro-fit the standardcassette sizes to retro-fit the standard
cephalometric and panoramic machines.cephalometric and panoramic machines.

Advantages :Advantages :
 Large sensor sizeLarge sensor size
 Disadvantages:Disadvantages:
 High sensor costHigh sensor cost
 Limited availability.Limited availability.

Transparency Scanner TechniqueTransparency Scanner Technique
 A conventional x-ray film is placed on theA conventional x-ray film is placed on the
scanner’s flat transparent surfacescanner’s flat transparent surface
& is scanned by a light source& is scanned by a light source
 The transmitted light is detected by aThe transmitted light is detected by a
CCD & is digitized into grey scaleCCD & is digitized into grey scale
intensitiesintensities

Cephalometric ApplicationsCephalometric Applications
 Possible to either get a direct digitalPossible to either get a direct digital
cephalogram of the patient or digitize acephalogram of the patient or digitize a
regular cephalogram for computerizedregular cephalogram for computerized
Cephalometry.Cephalometry.

Cephalometric applications offer treatmentCephalometric applications offer treatment
planning manipulations such asplanning manipulations such as
 Growth estimationGrowth estimation
 Orthopedic interventionOrthopedic intervention
 Orthodontic tooth movementOrthodontic tooth movement
 Orthognathic surgeryOrthognathic surgery

Advantages of computerizedAdvantages of computerized
cephalometry:cephalometry:
 It is fast and enables us to obtain a moreIt is fast and enables us to obtain a more
comprehensive diagnostic picture.comprehensive diagnostic picture.
 The need for templates and retracings ofThe need for templates and retracings of
acetate overlays is eliminated.acetate overlays is eliminated.

 An analysis can be performed in 10%An analysis can be performed in 10%
of the time of a normal manualof the time of a normal manual
registration because it is onlyregistration because it is only
necessary to identify the radiologicalnecessary to identify the radiological
points with the click of a mouse on apoints with the click of a mouse on a
computer monitor.computer monitor.
 The calculations are displayed withinThe calculations are displayed within
seconds. This process removesseconds. This process removes
human error except for errors ofhuman error except for errors of
landmark identification.landmark identification.

DigitizationDigitization
 Digitization is a process by which analogDigitization is a process by which analog
information is converted into digital forminformation is converted into digital form
 The Orthodontist can use eitherThe Orthodontist can use either
--digitizing tablet--digitizing tablet
--A mouse to digitize landmarks from a--A mouse to digitize landmarks from a
digital cephalogram displayed on adigital cephalogram displayed on a
CRT monitor or flat panel displayCRT monitor or flat panel display

 AA digitizing tabletdigitizing tablet / digitizer is an inexpensive/ digitizer is an inexpensive
accurate tool for digitizing cephalogramsaccurate tool for digitizing cephalograms
 A cursor is used to locate the landmarks &A cursor is used to locate the landmarks &
contours on the radiograph manually & record acontours on the radiograph manually & record a
sequence of x-y coordinates , which are thensequence of x-y coordinates , which are then
transmitted to the computer.transmitted to the computer.
 No intermediate acetate tracing requiredNo intermediate acetate tracing required
 Can be either opaque,translucent, orCan be either opaque,translucent, or
transparenttransparent

 Two parameters are used to measureTwo parameters are used to measure
digitizer performance:digitizer performance:
Resolution & accuracyResolution & accuracy
Resolution:Resolution:
It is the smallest distance that can beIt is the smallest distance that can be
resolved by the digitizer & is on the orderresolved by the digitizer & is on the order
of 1000 lines per inch (approx 40 linesof 1000 lines per inch (approx 40 lines
per mm) in contemporary tabletsper mm) in contemporary tablets

 AccuracyAccuracy::
 It is the precision with which a digitizerIt is the precision with which a digitizer
can record spatial measurements overcan record spatial measurements over
various regions of its surface; it shouldvarious regions of its surface; it should
be on the order of +/- 0.25 mm forbe on the order of +/- 0.25 mm for
cephalometric applications.cephalometric applications.

 Two modes of Digitization can be used toTwo modes of Digitization can be used to
record information from digitalrecord information from digital
cephalogram on the monitorcephalogram on the monitor
 -- Point mode-- Point mode
 -- Stream mode-- Stream mode
 Point ModePoint Mode: Refers to discrete location of: Refers to discrete location of
individual landmarks.individual landmarks.
 The user sequentially locates landmarks inThe user sequentially locates landmarks in
a predetermined order . Then thesea predetermined order . Then these
landmarks are connected with lines orlandmarks are connected with lines or
curves.curves.

Point Mode DigitizationPoint Mode Digitization

Stream Mode digitizationStream Mode digitization

 Stream ModeStream Mode Digitization is a processDigitization is a process
in which a stream of coordinate pairsin which a stream of coordinate pairs
is recorded as the user traces ais recorded as the user traces a
radiographic contour .radiographic contour .
 A large no. of adjacent points areA large no. of adjacent points are
transmitted & these are joined in atransmitted & these are joined in a
simple point to point fashion.simple point to point fashion.

 Point mode digitization is more timePoint mode digitization is more time
consuming but provide more accurateconsuming but provide more accurate
landmark locations.landmark locations.
 Stream mode is more technique sensitiveStream mode is more technique sensitive
than point mode. the operator must possesthan point mode. the operator must posses
considerable skill to record the contoursconsiderable skill to record the contours
accurately.accurately.
 Thus point mode digitization is preferredThus point mode digitization is preferred
method for predictive treatment planning.method for predictive treatment planning.

 These digital cephalometric images canThese digital cephalometric images can
be directly transferred to thebe directly transferred to the
cephalometric analysis or surgicalcephalometric analysis or surgical
planning program.planning program.
 Many cephalometric programs areMany cephalometric programs are
available, with variable content &available, with variable content &
capabilities.capabilities.
 So a cost to benefit ratio and relevance toSo a cost to benefit ratio and relevance to
specific needs is evaluated before optingspecific needs is evaluated before opting

C.A.O.SC.A.O.S WinMultimedia servicesWinMultimedia services
Dr. CephDr. Ceph FYI TechnologiesFYI Technologies
Orthotrac CephOrthotrac Ceph OrthotracOrthotrac
Quick ceph image proQuick ceph image pro Quickceph systemsQuickceph systems
PORDIOS or PurposePORDIOS or Purpose
On Request DigitalizerOn Request Digitalizer
Input Output SystemInput Output System
Institute of orthodonticInstitute of orthodontic
computer science,computer science,
DenmarkDenmark

Joe-JiffyJoe-Jiffy Rocky MountainRocky Mountain
OrthodonticsOrthodontics
Vistadent CephVistadent Ceph GACGAC
DigicephDigiceph E T & T / AIIMS, IndiaE T & T / AIIMS, India
ViewboxViewbox Dr. HalazonetisDr. Halazonetis
WincephWinceph Rise corporationRise corporation
Zerobase cephZerobase ceph Zerobase Inc. USAZerobase Inc. USA
OPALOPAL Dr. Nigel Harradine, UKDr. Nigel Harradine, UK

 SureSmile’s Promise-SureSmile’s Promise- Digital Care solutionsDigital Care solutions
for Orthodontic Industry-Rohit C.L.Sachdevafor Orthodontic Industry-Rohit C.L.Sachdeva

 SureSmile SoftwareSureSmile Software ——
 The SureSmile software allows the orthodontistThe SureSmile software allows the orthodontist
to visualize and plan different treatmentto visualize and plan different treatment
scenarios through the manipulation of digitalscenarios through the manipulation of digital
diagnostic set upsdiagnostic set ups
 It also designs customized orthodonticIt also designs customized orthodontic
appliances on a virtual workbench in three-appliances on a virtual workbench in three-
dimensional space.dimensional space.

 Different care modalities can be simulatedDifferent care modalities can be simulated
in real-time allowing the selection of anin real-time allowing the selection of an
appropriate treatment plan and applianceappropriate treatment plan and appliance
systemsystem..

This approach eliminates the error-prone and
time-consuming manual planning processes
associated with traditional approaches such as
diagnostic setups, VTOs and occlusograms

ConclusionConclusion
 Computer technology has the potential toComputer technology has the potential to
revolutionize orthodontic treatment andrevolutionize orthodontic treatment and
clinical management methods to theclinical management methods to the
extent that bonding techniques changedextent that bonding techniques changed
the clinical practice of orthodontics.the clinical practice of orthodontics.

 ReferencesReferences
 Orthodontics,curent principles & techniques-Orthodontics,curent principles & techniques-
Graber & VanarsdalGraber & Vanarsdal
 Computers in orthodontics- siemens et al,JCOComputers in orthodontics- siemens et al,JCO
19871987
 Computer application in orthodontics- recentComputer application in orthodontics- recent
advances- Jyothindra Kumar. 6advances- Jyothindra Kumar. 6thth
IOS P.GIOS P.G
Convention, MysoreConvention, Mysore
 Videoimaging: The pros and cons -David M.Videoimaging: The pros and cons -David M.
Sarver Angle Orthod, 1993 No. 3, 167 - 170:)Sarver Angle Orthod, 1993 No. 3, 167 - 170:)
 The DigiGraph Work Station Part 1 BasicThe DigiGraph Work Station Part 1 Basic
Concepts – Chaconas et al, JCO Volume 1990Concepts – Chaconas et al, JCO Volume 1990
Jun(360 - 367):Jun(360 - 367):

Thank YouThank You

Computers in orthodontics

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